Emergency Department Call for Family Physicians (Position Statement)

Hospital emergency department on-call coverage is a social and professional responsibility. An obligation to provide on-call coverage is often tied to hospital medical staff membership. Medical staff members who practice family medicine may find themselves disproportionately assigned to on-call schedules because they have clinical skills which cross multiple specialties. Such physicians may be assigned to on-call schedules for general medicine, pediatrics, neonates, obstetrics, etc. When this happens it may produce an untenable burden on the doctor and create a situation which is unfair and inequitable.

The AAFP recognizes that hospitals must meet their community responsibility and legal obligations to provide emergency medical care. This will generally require members of the medical staff to provide clinical expertise to supplement that provided by emergency department physicians. Family physicians should share in any on-call requirements in the same manner as their colleagues in other specialties. Family physicians should take call with a frequency that is comparable to their colleagues on the medical staff. For example, if the average frequency of call is three days per month, then a family physician should be on call no more than three days per month, even if some of this coverage is in pediatrics, some in general medicine, some in obstetrics, etc. If a hospital has not established a fair baseline of participation for each member of the medical staff it should be encouraged to do so. If a family physician is asked to take call at a rate greater than the baseline, he/she should be properly compensated for this requirement.

The practice of family medicine has become increasingly difficult in recent years, even as it remains a critical need in most communities. Despite their need to meet the requirements of the Emergency Treatment and Active Labor Act (EMTALA), hospitals and medical staffs must adopt policies which treat all physicians equitably. (March Board 2005) (2010 COD)